1.Program Definition and Services
Case management services in Michigan involve coordinating and linking individuals with needed medical, social, educational, and other services. These services are designed to support individuals in accessing necessary resources, enhancing their independence, and improving overall well-being. Case management includes assessment, service planning, linking to services, monitoring, and advocacy
2. Regulations
Key regulations governing case management services include:
- Michigan Medicaid Regulations: Services must comply with Medicaid standards for reimbursement, including targeted case management services
- Federal Requirements: Providers must adhere to federal guidelines for case management, ensuring services are not duplicated and are provided in accordance with individual needs
3. Licensing or Certification
To operate as a case management provider, organizations typically need to be enrolled as Medicaid providers. While not mandatory, case managers may benefit from certifications like the Certified Case Manager (CCM) credential, which demonstrates expertise in case management practices.
4. Responsible State Agency
The Michigan Department of Health and Human Services (MDHHS) oversees Medicaid services, including case management.
5. Application Process
Providers must enroll as Medicaid providers through the CHAMPS (Community Health Automated Medicaid Processing System) online platform. For targeted case management, providers must meet specific criteria outlined in state Medicaid plans
6. Required Documentation
- Business Registration Documents: Proof of business registration in Michigan.
- Insurance and Liability Coverage: Proof of adequate insurance coverage.
- Staff Qualifications: Documentation of staff qualifications, including licenses and certifications.
- Medicaid Enrollment Forms: Completed forms for Medicaid provider enrollment.
- Case Management Experience: Documentation of experience in coordinating community resources
7. Timeline for Approval
The approval timeline varies depending on the completeness of the application. Generally, it can take several weeks to a few months.
8. Pre-Application Process
Prospective providers should familiarize themselves with state and federal regulations before applying.
9. Pre-Application Training
While not explicitly mandated, providers must ensure their staff are trained in case management principles and practices. Training may include courses on person-centered planning and evidence-based practices
10. Additional Notes
- Person-Centered Planning: Providers must adhere to principles of person-centered planning to ensure services meet individual needs and goals
- Community Partnerships: Building partnerships with community organizations is crucial for effective service delivery
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